Lee Health Average Charge per DRG FY 2018 (10/1/2017-9/30/2018) Inpatients, All Payors AVERAGE DRG DRG NAME CHG/ CASE

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1 Lee Health Average Charge per DRG FY 2018 (10/1/2017-9/30/2018) Inpatients, All Payors AVERAGE DRG DRG NAME CHG/ CASE 795 NORMAL NEWBORN 3, RADIOTHERAPY 5, NEONATE W OTHER SIGNIFICANT PROBLEMS 6, EAR, NOSE, MOUTH & THROAT MALIGNANCY W/O CC/MCC 12, SKIN ULCERS W/O CC/MCC 13, OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC 13, FALSE LABOR 14, OTITIS MEDIA & URI W/O MCC 14, VIRAL MENINGITIS W/O CC/MCC 14, OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W/O CC/MCC 14, ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC 14, OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS 15, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC 15, MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC 15, ACUTE MAJOR EYE INFECTIONS W CC/MCC 15, MAJOR SKIN DISORDERS W/O MCC 16, MINOR SKIN DISORDERS W/O MCC 16, VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES 16, OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC 16, VIRAL ILLNESS W/O MCC 16, MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC 17, BRONCHITIS & ASTHMA W/O CC/MCC 17, SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC 17, DIABETES W/O CC/MCC 17, NON-EXTENSIVE BURNS 17, THREATENED ABORTION 18, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC 18, ABORTION W/O D&C 18, DENTAL & ORAL DISEASES W/O CC/MCC 18, EPISTAXIS W/O MCC 18, ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA 19,019 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 1 of 20 1/2/2019

2 923 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC 19, ALLERGIC REACTIONS W/O MCC 19, G.I. OBSTRUCTION W/O CC/MCC 19, RENAL FAILURE W/O CC/MCC 19, CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC 19, RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC 19, VAGINAL DELIVERY W COMPLICATING DIAGNOSES 19, BENIGN PROSTATIC HYPERTROPHY W/O MCC 19, KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC 19, SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC 19, POISONING & TOXIC EFFECTS OF DRUGS W/O MCC 19, ENDOCRINE DISORDERS W/O CC/MCC 19, PSYCHOSES 19, CELLULITIS W/O MCC 20, MAJOR SKIN DISORDERS W MCC 20, PERIPHERAL VASCULAR DISORDERS W/O CC/MCC 20, NEUROSES EXCEPT DEPRESSIVE 20, DEPRESSIVE NEUROSES 20, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC 20, MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC 20, CARDIAC ARREST, UNEXPLAINED W/O CC/MCC 20, INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC 20, CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC 20, CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT 20, MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC 21, SKIN ULCERS W CC 21, POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE 21, NON-MALIGNANT BREAST DISORDERS W/O CC/MCC 21, G.I. HEMORRHAGE W/O CC/MCC 21, MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC 21, HEART FAILURE & SHOCK W/O CC/MCC 21, OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC 21, PREMATURITY W/O MAJOR PROBLEMS 21, OTHER FACTORS INFLUENCING HEALTH STATUS 21, OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC 21, CONNECTIVE TISSUE DISORDERS W/O CC/MCC 22, TENDONITIS, MYOSITIS & BURSITIS W/O MCC 22, COMPLICATIONS OF TREATMENT W/O CC/MCC 22,279 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 2 of 20 1/2/2019

3 760 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC 22, RED BLOOD CELL DISORDERS W/O MCC 22, ACUTE MAJOR EYE INFECTIONS W/O CC/MCC 22, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC 22, SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC 22, CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC 22, ANGINA PECTORIS 23, FRACTURES OF FEMUR W/O MCC 23, INFLAMMATORY BOWEL DISEASE W/O CC/MCC 23, ATHEROSCLEROSIS W/O MCC 23, OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC 23, KIDNEY & URINARY TRACT INFECTIONS W/O MCC 23, CHEST PAIN 23, SEPTIC ARTHRITIS W/O CC/MCC 23, BONE DISEASES & ARTHROPATHIES W/O MCC 23, LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC 24, ORBITAL PROCEDURES W/O CC/MCC 24, MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC 24, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC 24, BEHAVIORAL & DEVELOPMENTAL DISORDERS 24, INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC 24, CESAREAN SECTION W/O CC/MCC 24, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC 24, OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC 24, PLEURAL EFFUSION W/O CC/MCC 24, DIABETES W CC 24, VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C 24, MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC 24, URETHRAL STRICTURE 25, NONTRAUMATIC STUPOR & COMA W MCC 25, ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC 25, OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC 25, ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC 25, DEEP VEIN THROMBOPHLEBITIS W CC/MCC 25, FEVER 25, OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC 25, G.I. OBSTRUCTION W CC 25, PNEUMOTHORAX W/O CC/MCC 25,774 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 3 of 20 1/2/2019

4 544 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC 25, FRACTURES OF HIP & PELVIS W/O MCC 25, ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W/O CC/MCC 25, ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY 25, RENAL FAILURE W CC 26, SEIZURES W/O MCC 26, DENTAL & ORAL DISEASES W CC 26, UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W/O CC/MCC 26, DISORDERS OF THE BILIARY TRACT W/O CC/MCC 26, OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS 26, VIRAL ILLNESS W MCC 26, DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC 26, OTHER MENTAL DISORDER DIAGNOSES 26, HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC 26, KIDNEY & URINARY TRACT NEOPLASMS W MCC 26, MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC 26, ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION 26, HYPERTENSION W/O MCC 26, INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC 26, RESPIRATORY NEOPLASMS W/O CC/MCC 27, POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC 27, HEART FAILURE & SHOCK W CC 27, NONTRAUMATIC STUPOR & COMA W/O MCC 27, VIRAL MENINGITIS W CC/MCC 27, SIMPLE PNEUMONIA & PLEURISY W CC 27, KIDNEY & URINARY TRACT NEOPLASMS W/O CC/MCC 27, NERVOUS SYSTEM NEOPLASMS W/O MCC 27, RESPIRATORY SIGNS & SYMPTOMS 27, INFLAMMATORY BOWEL DISEASE W CC 27, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC 28, VAGINAL DELIVERY W STERILIZATION &/OR D&C 28, COMPLICATIONS OF TREATMENT W CC 28, FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC 28, HEADACHES W MCC 28, ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC 28, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC 28, TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC 28, TRAUMATIC INJURY W/O MCC 28,795 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 4 of 20 1/2/2019

5 561 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 28, HEADACHES W/O MCC 28, OTHER DISORDERS OF THE EYE W/O MCC 28, URINARY STONES W/O ESW LITHOTRIPSY W/O MCC 29, DYSEQUILIBRIUM 29, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC 29, CESAREAN SECTION W CC/MCC 29, TESTES PROCEDURES W/O CC/MCC 29, RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC 29, PULMONARY EMBOLISM W/O MCC 29, DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC 29, SKIN ULCERS W MCC 29, BRONCHITIS & ASTHMA W CC/MCC 29, G.I. HEMORRHAGE W CC 29, NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC 30, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC 30, PERIPHERAL VASCULAR DISORDERS W CC 30, BENIGN PROSTATIC HYPERTROPHY W MCC 30, OTHER CIRCULATORY SYSTEM DIAGNOSES W CC 30, OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC 30, CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W/O CC/MCC 30, PLEURAL EFFUSION W CC 30, NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY 30, INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC 30, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC 30, MINOR SKIN DISORDERS W MCC 30, D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W/O CC/MCC 30, UNCOMPLICATED PEPTIC ULCER W/O MCC 30, FULL TERM NEONATE W MAJOR PROBLEMS 30, OTHER DIGESTIVE SYSTEM DIAGNOSES W CC 30, CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC 31, ACUTE & SUBACUTE ENDOCARDITIS W/O CC/MCC 31, SYNCOPE & COLLAPSE 31, COMPLICATED PEPTIC ULCER W CC 31, TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC 31, COMPLICATED PEPTIC ULCER W/O CC/MCC 31, RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC 31, SIGNS & SYMPTOMS W/O MCC 31,552 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 5 of 20 1/2/2019

6 433 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC 31, OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC 31, OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC 31, LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC 31, EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC 31, INTERSTITIAL LUNG DISEASE W/O CC/MCC 32, ENDOCRINE DISORDERS W CC 32, POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC 32, INTERSTITIAL LUNG DISEASE W CC 32, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC 32, TRANSIENT ISCHEMIA W/O THROMBOLYTIC 32, ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY 32, OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC 32, HYPERTENSION W MCC 33, HYPERTENSIVE ENCEPHALOPATHY W MCC 33, VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC 33, SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC 33, OTHER DISORDERS OF THE EYE W MCC 33, OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC 33, KIDNEY & URINARY TRACT INFECTIONS W MCC 33, ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC 34, HYPERTENSIVE ENCEPHALOPATHY W CC 34, OTHER DISORDERS OF NERVOUS SYSTEM W CC 34, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC 34, SKIN DEBRIDEMENT W/O CC/MCC 34, DISORDERS OF PERSONALITY & IMPULSE CONTROL 34, TRANSURETHRAL PROSTATECTOMY W/O CC/MCC 34, INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W/O CC/MCC 34, HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC 34, SEPTIC ARTHRITIS W CC 34, KIDNEY & URINARY TRACT NEOPLASMS W CC 35, FRACTURES OF HIP & PELVIS W MCC 35, NEUROLOGICAL EYE DISORDERS 35, AFTERCARE W/O CC/MCC 35, CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC 35, PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC 35, NONSPECIFIC CEREBROVASCULAR DISORDERS W CC 35, WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC 35,787 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 6 of 20 1/2/2019

7 552 MEDICAL BACK PROBLEMS W/O MCC 35, MINOR BLADDER PROCEDURES W/O CC/MCC 35, ANAL & STOMAL PROCEDURES W CC 35, OSTEOMYELITIS W/O CC/MCC 36, NON-MALIGNANT BREAST DISORDERS W CC/MCC 36, DISORDERS OF THE BILIARY TRACT W CC 36, OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC 36, UNCOMPLICATED PEPTIC ULCER W MCC 36, CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC 36, AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 36, MOUTH PROCEDURES W/O CC/MCC 37, PERIPHERAL VASCULAR DISORDERS W MCC 37, ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC 37, TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC 37, CONNECTIVE TISSUE DISORDERS W CC 37, BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC 37, FRACTURES OF FEMUR W MCC 37, HIV W MAJOR RELATED CONDITION W/O CC/MCC 37, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC 37, INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC 37, MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC 37, OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC 38, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC 38, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC 38, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC 38, PROSTATECTOMY W/O CC/MCC 38, OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC 38, MALIGNANT BREAST DISORDERS W CC 39, OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC 39, ECTOPIC PREGNANCY 39, POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE 39, MAJOR ESOPHAGEAL DISORDERS W CC 39, MAJOR CHEST TRAUMA W/O CC/MCC 39, DIGESTIVE MALIGNANCY W CC 39, FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC 39, KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W MCC 39, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC 40, COAGULATION DISORDERS 40,539 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 7 of 20 1/2/2019

8 385 INFLAMMATORY BOWEL DISEASE W MCC 40, DIABETES W MCC 40, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS 40, DIGESTIVE MALIGNANCY W/O CC/MCC 41, EXTRAOCULAR PROCEDURES EXCEPT ORBIT 41, POISONING & TOXIC EFFECTS OF DRUGS W MCC 41, OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC 41, CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC 41, HEART FAILURE & SHOCK W MCC 41, SPINAL DISORDERS & INJURIES W/O CC/MCC 41, OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC 41, PNEUMOTHORAX W CC 41, NERVOUS SYSTEM NEOPLASMS W MCC 41, INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC 41, AFTERCARE W CC/MCC 41, DENTAL & ORAL DISEASES W MCC 41, OTITIS MEDIA & URI W MCC 42, SIMPLE PNEUMONIA & PLEURISY W MCC 42, OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W/O CC/MCC 42, CRANIAL & PERIPHERAL NERVE DISORDERS W MCC 42, SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W/O CC/MCC 42, MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC 42, OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W/O CC/MCC 43, ATHEROSCLEROSIS W MCC 43, PENIS PROCEDURES W/O CC/MCC 43, RESPIRATORY INFECTIONS & INFLAMMATIONS W CC 43, PULMONARY EMBOLISM W MCC 43, NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC 43, DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC 43, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 43, BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC 44, LYMPHOMA & NON-ACUTE LEUKEMIA W CC 44, MAJOR CHEST TRAUMA W CC 44, HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC 44, RENAL FAILURE W MCC 44, MOUTH PROCEDURES W CC/MCC 44, CELLULITIS W MCC 44, SEPTIC ARTHRITIS W MCC 44,870 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 8 of 20 1/2/2019

9 540 OSTEOMYELITIS W CC 44, RESPIRATORY NEOPLASMS W CC 44, INTERSTITIAL LUNG DISEASE W MCC 45, TRANSURETHRAL PROCEDURES W/O CC/MCC 45, SOFT TISSUE PROCEDURES W/O CC/MCC 45, RED BLOOD CELL DISORDERS W MCC 45, HIV W OR W/O OTHER RELATED CONDITION 45, HIV W MAJOR RELATED CONDITION W CC 45, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC 45, HAND PROCEDURES FOR INJURIES 46, PULMONARY EDEMA & RESPIRATORY FAILURE 46, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC 46, OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC 46, APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC 46, SALIVARY GLAND PROCEDURES 46, SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W CC/MCC 46, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC 46, SEIZURES W MCC 46, TRAUMATIC STUPOR & COMA, COMA <1 HR W CC 46, COMPLICATIONS OF TREATMENT W MCC 46, OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC 47, CONCUSSION W/O CC/MCC 47, DISORDERS OF THE BILIARY TRACT W MCC 47, INTRAOCULAR PROCEDURES W/O CC/MCC 47, SKIN DEBRIDEMENT W CC 47, TRANSURETHRAL PROCEDURES W CC 47, UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC 48, ENDOCRINE DISORDERS W MCC 48, OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC 48, NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC 49, URINARY STONES W ESW LITHOTRIPSY W CC/MCC 49, G.I. OBSTRUCTION W MCC 49, MALIGNANT BREAST DISORDERS W MCC 49, COMPLICATED PEPTIC ULCER W MCC 49, ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC 49, POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC 49, OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC 49, VAGINA, CERVIX & VULVA PROCEDURES W CC/MCC 49,570 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 9 of 20 1/2/2019

10 489 KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC 49, OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC 49, TRAUMATIC INJURY W MCC 50, CONCUSSION W CC 50, TRANSURETHRAL PROSTATECTOMY W CC/MCC 50, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC 50, OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC 50, ANAL & STOMAL PROCEDURES W/O CC/MCC 50, RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MCC 50, CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC 50, SIGNS & SYMPTOMS W MCC 50, AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 51, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC 51, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC 51, MAJOR CHEST TRAUMA W MCC 51, NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC 51, SKIN GRAFTS FOR INJURIES W/O CC/MCC 51, ORBITAL PROCEDURES W CC/MCC 51, OTHER SKIN, SUBCUT TISS & BREAST PROC W CC 52, PNEUMOTHORAX W MCC 52, MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC 52, THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W/O CC/MCC 52, INGUINAL & FEMORAL HERNIA PROCEDURES W CC 52, OTHER DISORDERS OF NERVOUS SYSTEM W MCC 53, SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC 53, MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC 53, LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W/O CC/MCC 53, G.I. HEMORRHAGE W MCC 53, ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC 53, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC 53, TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC 53, CONCUSSION W MCC 53, TRAUMATIC STUPOR & COMA, COMA >1 HR W CC 53, BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC 54, RESPIRATORY NEOPLASMS W MCC 54, SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC 54, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC 54, MEDICAL BACK PROBLEMS W MCC 54,829 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 10 of 20 1/2/2019

11 675 OTHER KIDNEY & URINARY TRACT PROCEDURES W/O CC/MCC 54, DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC 55, URINARY STONES W/O ESW LITHOTRIPSY W MCC 55, FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES 55, ACUTE & SUBACUTE ENDOCARDITIS W CC 55, D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W CC/MCC 55, INTRAOCULAR PROCEDURES W CC/MCC 55, LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC 56, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC 56, BONE DISEASES & ARTHROPATHIES W MCC 56, CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC 56, MAJOR ESOPHAGEAL DISORDERS W MCC 56, TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC 57, PROSTATECTOMY W CC 57, PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W/O CC/MCC 57, OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC 57, OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC 57, APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC 57, FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ 57, SPINAL DISORDERS & INJURIES W CC/MCC 58, SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 58, TENDONITIS, MYOSITIS & BURSITIS W MCC 58, SOFT TISSUE PROCEDURES W CC 58, DIGESTIVE MALIGNANCY W MCC 58, HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC 58, KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC 58, DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC 58, OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC 59, PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC 59, LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W CC 59, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 59, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC 60, EPISTAXIS W MCC 60, VENTRICULAR SHUNT PROCEDURES W/O CC/MCC 60, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC 60, ADRENAL & PITUITARY PROCEDURES W/O CC/MCC 60, OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC/MCC 60, OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC 60,608 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 11 of 20 1/2/2019

12 262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC 60, CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC 60, RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC 60, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC 60, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC 60, OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC 61, CONNECTIVE TISSUE DISORDERS W MCC 61, MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC 61, NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC 61, MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDU 61, PLEURAL EFFUSION W MCC 61, URINARY STONES W ESW LITHOTRIPSY W/O CC/MCC 61, OTHER O.R. PROCEDURES FOR INJURIES W CC 61, MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC 61, O.R. PROCEDURES FOR OBESITY W/O CC/MCC 62, LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC 62, UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC 62, MINOR BLADDER PROCEDURES W CC 62, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC 62, O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC 62, OTHER RESP SYSTEM O.R. PROCEDURES W CC 62, FOOT PROCEDURES W MCC 62, SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC 63, UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC 63, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC 63, NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC 64, WOUND DEBRIDEMENTS FOR INJURIES W CC 64, PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC 64, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC 64, CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC 64, ALLERGIC REACTIONS W MCC 64, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC 64, CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC 64, OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W MCC 64, PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC 65, HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC 65, MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC 65, SINUS & MASTOID PROCEDURES W CC/MCC 66,045 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 12 of 20 1/2/2019

13 539 OSTEOMYELITIS W MCC 66, FOOT PROCEDURES W CC 66, CRANIAL/FACIAL PROCEDURES W/O CC/MCC 66, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC 66, MAJOR THUMB OR JOINT PROCEDURES 67, O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS 67, BACK & NECK PROC EXC SPINAL FUSION W CC 67, ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC 68, OTHER MULTIPLE SIGNIFICANT TRAUMA W CC 68, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC 68, OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W CC/MCC 69, SPINAL PROCEDURES W/O CC/MCC 69, PERITONEAL ADHESIOLYSIS W/O CC/MCC 69, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC 69, UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC 69, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC 69, POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC 70, LYMPHOMA & NON-ACUTE LEUKEMIA W MCC 70, OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC 70, MINOR SMALL & LARGE BOWEL PROCEDURES W CC 70, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC 71, ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC 71, EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC 71, SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC 72, MAJOR MALE PELVIC PROCEDURES W/O CC/MCC 72, URETHRAL PROCEDURES W CC/MCC 72, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC 72, ADRENAL & PITUITARY PROCEDURES W CC/MCC 72, WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC 72, CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC 73, INGUINAL & FEMORAL HERNIA PROCEDURES W MCC 73, EXTRACRANIAL PROCEDURES W/O CC/MCC 73, UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W/O CC/MCC 73, OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC 73, MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 73, OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC 73, O.R. PROCEDURES FOR OBESITY W CC 73, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC 73,939 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 13 of 20 1/2/2019

14 410 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC 74, OTHER KIDNEY & URINARY TRACT PROCEDURES W CC 74, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC 74, AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W CC 74, KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC 74, CARDIAC ARREST, UNEXPLAINED W MCC 74, PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC 75, SOFT TISSUE PROCEDURES W MCC 75, SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC 75, LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC 76, OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W CC 76, STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC 76, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 76, CHOLECYSTECTOMY W C.D.E. W/O CC/MCC 76, EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC 76, THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W MCC 76, SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC 76, HIV W MAJOR RELATED CONDITION W MCC 76, VENTRICULAR SHUNT PROCEDURES W CC 77, SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC 77, FOOT PROCEDURES W/O CC/MCC 77, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 77, SPLENECTOMY W/O CC/MCC 78, RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS 78, SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC 78, TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC 78, MINOR SMALL & LARGE BOWEL PROCEDURES W MCC 78, INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC 79, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC 79, CERVICAL SPINAL FUSION W/O CC/MCC 79, MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES 80, APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W MCC 80, MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC 80, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC 81, ACUTE & SUBACUTE ENDOCARDITIS W MCC 81, SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 81, ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGEN 81, PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC 82,030 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 14 of 20 1/2/2019

15 243 PERMANENT CARDIAC PACEMAKER IMPLANT W CC 82, O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC 82, KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC 82, UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W CC 82, MASTECTOMY FOR MALIGNANCY W CC/MCC 82, OTHER VASCULAR PROCEDURES W/O CC/MCC 82, LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC 83, EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC 83, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC 83, PERITONEAL ADHESIOLYSIS W CC 83, UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC 83, MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC 83, MINOR BLADDER PROCEDURES W MCC 84, FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC/MCC 84, OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W MCC 84, ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGEN 85, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC 85, O.R. PROCEDURES FOR OBESITY W MCC 85, PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC 86, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC 87, PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W CC/MCC 87, PENIS PROCEDURES W CC/MCC 87, MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W MCC 87, CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC 88, SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC 89, VENTRICULAR SHUNT PROCEDURES W MCC 91, CAROTID ARTERY STENT PROCEDURE W/O CC/MCC 91, CRANIAL/FACIAL PROCEDURES W CC/MCC 91, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC 92, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC 92, THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W CC 92, PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC 94, PREMATURITY W MAJOR PROBLEMS 94, HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC 94, CERVICAL SPINAL FUSION W CC 95, RECTAL RESECTION W/O CC/MCC 95, PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC 96, SKIN DEBRIDEMENT W MCC 96,456 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 15 of 20 1/2/2019

16 486 KNEE PROCEDURES W PDX OF INFECTION W CC 97, SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC 97, MAJOR MALE PELVIC PROCEDURES W CC/MCC 97, MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC 98, REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC 98, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM 98, OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC 98, EXTRACRANIAL PROCEDURES W CC 99, OTHER RESP SYSTEM O.R. PROCEDURES W MCC 99, MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDU 99, TRANSURETHRAL PROCEDURES W MCC 100, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC 101, STOMACH, ESOPHAGEAL & DUODENAL PROC W CC 101, KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC 102, MAJOR SMALL & LARGE BOWEL PROCEDURES W CC 102, MAJOR HEAD & NECK PROCEDURES W/O CC/MCC 102, BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC 102, OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC 103, OTHER CIRCULATORY SYSTEM O.R. PROCEDURES 103, OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC 103, PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR 4+ ARTE 103, PERMANENT CARDIAC PACEMAKER IMPLANT W MCC 104, WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC 104, AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC 105, OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC 106, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC 106, PANCREAS, LIVER & SHUNT PROCEDURES W CC 106, MAJOR CHEST PROCEDURES W/O CC/MCC 107, OTHER VASCULAR PROCEDURES W CC 107, OTHER VASCULAR PROCEDURES W MCC 108, LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W CC 108, OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC 108, MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR 108, UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W MCC 108, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC 109, KNEE PROCEDURES W PDX OF INFECTION W MCC 109, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC 110, BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM 110,266 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 16 of 20 1/2/2019

17 35 CAROTID ARTERY STENT PROCEDURE W CC 111, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC 111, LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC 112, LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W MCC 113, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W MCC 113, OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC 113, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC 114, URETHRAL PROCEDURES W/O CC/MCC 115, ANAL & STOMAL PROCEDURES W MCC 117, PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTERIES 118, O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W MCC 119, ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGEN 120, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC 120, OTHER O.R. PROCEDURES FOR INJURIES W MCC 121, SPLENECTOMY W CC 121, OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC 121, MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR DEVICE 121, PERITONEAL ADHESIOLYSIS W MCC 121, UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC 122, OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W CC/MCC 123, SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS 123, PROSTATECTOMY W MCC 124, SKIN GRAFTS FOR INJURIES W CC/MCC 124, CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC 125, AICD GENERATOR PROCEDURES 126, POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC 126, INBORN AND OTHER DISORDERS OF METABOLISM 127, EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC 129, AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC 129, MAJOR CHEST PROCEDURES W CC 129, OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC 129, AICD LEAD PROCEDURES 131, SPINAL FUSION EXCEPT CERVICAL W/O MCC 131, REVISION OF HIP OR KNEE REPLACEMENT W CC 132, PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC 132, RECTAL RESECTION W CC 134, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC 134, KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC 135,638 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 17 of 20 1/2/2019

18 654 MAJOR BLADDER PROCEDURES W CC 136, UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W MCC 136, MAJOR CHEST PROCEDURES W MCC 138, BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC 140, BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC 140, SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC 140, EXTRACRANIAL PROCEDURES W MCC 141, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC 141, VEIN LIGATION & STRIPPING 143, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC 147, SPLENECTOMY W MCC 148, NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC 150, CORONARY BYPASS W/O CARDIAC CATH W/O MCC 150, HIV W EXTENSIVE O.R. PROCEDURE W MCC 151, WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC 152, MAJOR BLADDER PROCEDURES W MCC 152, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC 152, RECTAL RESECTION W MCC 153, CERVICAL SPINAL FUSION W MCC 153, OTHER CARDIOTHORACIC PROCEDURES W/O MCC 157, WOUND DEBRIDEMENTS FOR INJURIES W MCC 158, INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC 159, CAROTID ARTERY STENT PROCEDURE W MCC 160, TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W/O CC/MCC 161, CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA 161, ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC 168, MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC 170, TESTES PROCEDURES W CC/MCC 170, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC 170, LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA 170, SPINAL PROCEDURES W MCC 173, CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC 174, OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W CC 174, CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC 178, OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC 179, LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W MCC 180, REVISION OF HIP OR KNEE REPLACEMENT W MCC 182, AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC 182,941 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 18 of 20 1/2/2019

19 616 AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W MCC 184, CORONARY BYPASS W CARDIAC CATH W/O MCC 186, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC 186, SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS 189, CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W/O MCC 190, RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS 191, STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC 191, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC 192, CORONARY BYPASS W/O CARDIAC CATH W MCC 194, CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE CNS PDX W MCC OR CHEMOTHERAPY IMPLANT 201, CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC 202, PANCREAS, LIVER & SHUNT PROCEDURES W MCC 204, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC 212, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC 214, CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC 217, OTHER CARDIOTHORACIC PROCEDURES W MCC 220, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC 222, AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC 228, CORONARY BYPASS W PTCA W/O MCC 230, SPINAL FUSION EXCEPT CERVICAL W MCC 234, TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W MCC 240, CORONARY BYPASS W CARDIAC CATH W MCC 249, ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC 250, CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC 258, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC 260, EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE 265, OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC 265, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W MCC 265, TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W CC 275, CORONARY BYPASS W PTCA W MCC 280, CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC 294, OTHER HEART ASSIST SYSTEM IMPLANT 314, ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC 314, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC 316, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC 337, BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC 348, INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC 355, INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC 387,383 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 19 of 20 1/2/2019

20 652 KIDNEY TRANSPLANT 409,288 4 TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. 469,510 1 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W MCC 498,346 3 ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. 505,656 Inpatient DRGs Charge Per Case FY18 sorted.xlsx Page 20 of 20 1/2/2019